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Maladies of My Mind – Ch. 2 Sticks and Stones

Maladies of My Mind

20 Years Later

Ch. 2 Sticks and Stones

Screams pierce the air as the smoke engulfs my father’s praying room and the collapsing wooden roof mows down a group of monks in orange gown. A strangled cry comes from my throat but no words follow. I lost grip of my icy demeanor, when I see the fire creeping towards me. I inch my hands to my ears, trying to block out the angry sounds of the crackling flames. When I straddle the corner, I swing my right foot up over the side. Suddenly, I feel something catch my feet, dragging me across the floor. Panting and trembling, I try to crawl away from the grasp and grab the edge of the wall for anchor. The image of my mom rushes back to me. I remember her anguish cry and her shaking body as the shaman whips her repeatedly with a dried stingray tail.

“Mom…” I croak into the abyss, heedless of being recognized. “Mom…”

“You need to get out of here!” I turn my head towards the source of wilderment and catch a glimpse of a pair of eyes that scare me to my bones. Father.

I smell the leaking gas nearby and the next thing I know is that my father is carrying my body as he limps towards the door. We are so close…for a moment my father looks at me.

Then, he flings my body and I stumble to the outside world. I open my mouth to call after him but that is when I see an explosive shockwave consuming everything and everyone in its path.

There are ringing in my ears. My head throbs and I want to vomit. But soon the nauseous feeling is replaced by a single sensation—agony. Flame runs its tongue up the back of my body and I can’t feel anything else but the unrelenting burning of my flesh. I open my eyes to see my brother, Awut.

‘You’re not supposed to be here,’ I want to say. Father will be upset if he finds out Awut comes to his praying room. So what is he doing here and why on earth is my older brother holding an oil container and a lighter in his hands?

I jolt awake in bed, gasping. I can barely breathe as my lungs heave in an attempt to suck in air. ‘It’s just another dream,’ I remind myself. I look around frantically. The unwelcoming white walls blind me, and the smell of harsh cleaning solvents fill my nostrils. The floors are black and white tiles arranged in checked patterns, and the walls are interrupted by sets of glass, revealing views of the bustling Bangkok city outside.

I turn to the side and notice a bright neon sticky note on the nightstand with a neat cursive handwriting on it. I pull the note off and take a closer look at it. “Your clothes are folded in the closet,” I read quietly. That’s odd. When I wake up at a stranger’s place, I usually find my clothes scattered across the floor.

After I am dressed, I find the man I came back with last night sitting by the kitchen table. Noticing that the man is reading a newspaper, I try to walk out of the apartment as discreetly as possible. I stop when he says, “Good morning, birdie.”

He has a weird accent and is a lot paler than most people I’ve seen in Thailand. I can’t tell his ethnicity, which is unusual around here, considering how few foreigners there are since the military coup in Bangkok a couple months ago. He looks Caucasian. No wait, Thai. A mix maybe. I don’t know but he’s attractive in a way that distracts me.

Before I could utter a response, the man walks up to me and says, “Are you free this weekend, Orasa? I have an extra ticket to a Thai boxing match this weekend.”

I’m slightly taken back. The man with the weird accent just replaced ‘birdie’ with my actual name and asked me out on a date. I thought I told him not to get attached.

“Look…” I try to remember his name.

“I’m Sujin,” he beats me to it.

“Oh,” I nod slightly, biting my lips as my cheeks color. “Look…Sujin. You seem like a nice guy but I’m just not looking for a relationship right now,” I use the same line I’ve rehearsed many times before to men and occasionally women I hooked up with. I roll my hair back and confine it with a clip I found in my pant pocket. I’m all business now, taking refuge in the formality of my professionalism. “I have to go to work if you’ll excuse me– ”

Sujin pops a grape into my mouth, “Aye, Orasa. You’re one rude birdie. First, not remembering my name and now you’re going to leave without eating my home cooked breakfast.” Taking advantage of my befuddlement, he grabs my hand and tugs me to the kitchen table. He places me on a seat and heads to the kitchen. He returns with two plates of breakfast and says, “I couldn’t recognize you at first but now that you roll your hair back like that, I think I’ve seen you at the hospital before.”

I flinch. Is he a patient? Or is he a hospital staff member? This is bad. What if he’s one of my co-workers? I gulp. I tend to forget a lot of faces at work; and I don’t want to break my personal rule of not getting involved with someone I work with. I speak casually, “So, are you a patient?”

“No, I’m a doctor,” he replies.

I pretend to act cool. “I see. So, what department do you work in?” Please not surgery. Please not surgery. I chant mentally.

“I’m the new attending psychiatrist,” he adds enthusiastically. “I just moved here from the States. I’m originally from the UK though. My father’s British and my mother’s Thai. To be honest, I’m quite excited to back in my mother’s home country.”

He gives out too much familial information for my taste. Nevertheless, I’m relieved. At least psychiatrists and surgeons in Thailand do not interact that much and I probably won’t see him again. Soon my relief turns into confusion. I look around the room and notice Sujin has a nice apartment. From what I recall last night, he has a fancy sports car too. I blurt, “How much money do you make?” A long silence follows and I break it, “I mean, this isn’t the States. Thai people don’t use shrinks. Shouldn’t you be broke or something?”

He stares at me. I didn’t mean to offend him because I was actually curious. But it’s probably better this way. No strings attached.

Finally, he smiles and pushes a plate of breakfast towards me. Thai people tend to eat porridge for breakfast but I notice that Sujin has prepared a Western style breakfast. He made me bacon and scrambled eggs with grapes in one corner of the plate and steamed vegetables in another. I look up and notice that he isn’t eating his breakfast but using his fork to separate the corns, carrots and broccoli from the vegetables mix into their own smaller piles based on the types of vegetables. Without looking up from his plate, he says, “Oh, don’t worry about it, birdie. I have Obsessive Compulsive Disorder. I’m better now though. I used to pop tons of pills.”

I’m surprised at how casually he reveals this private information. Finally, I manage a question. “How can you admit it so easily?”

He looks up from his plate and returns my gaze. “Would you hide the fact that you can’t produce insulin if you have diabetes?” He explains, adding quietly and sitting straight, “Psychological actions can result from of physiological causes; and I think we shouldn’t treat mental illness differently from other diseases.”

I take in his words but don’t say anything. I look at my breakfast and take a spoonful of steamed vegetables into my mouth.

The hospital corridor is stale and the air has a tinge of bleach. The walls are white and are dented in places from the patient trolleys that have countlessly bumped into them. The portraits on the walls are prints of the Thai royal family and above the sliding glass doors is a slim red plastic sign with bolded white letters that say ‘Emergency Room.’

Wearing my blue surgical scrubs and surgical cap, I am standing by the Emergency Room’s entrance and waiting for my patient to arrive. The patient is being transferred from the outskirts of Bangkok to a city hospital. The patient is a thirty-seven year-old female victim of an acid attack. According to the police reports, the jealous husband is a suspect. However, there are no witnesses other than the victim, who is in critical condition. The medical effects of sulfuric acid to the face are extensive. The severity of the damage depends on the concentration of the acid and the time before the acid is thoroughly washed off. However, according to the paramedics’ reports, the acid has rapidly eaten away the patient’s skin, layers of fat beneath the skin and underlying bone. The patient’s skull is partially deformed and her nostrils are closed off completely due to destroyed cartilage. She has also inhaled the acid vapor, which exacerbates the restriction of her airway.

I close my eyes for a moment, trying to conjure and mentally prepare for all the complications that could arise during the surgical procedure. Not everyone appreciates the attractions of surgery like I do. When I was a medical student in the operating room for the first time, and I saw a surgeon press the scalpel to someone’s body and open it like a juicy peach, there were two types of reaction. You either gagged in disgust or gaped in awe. I elicited the latter reaction. It is not just the blood and guts that entice me. It is the idea that a mere human being could have so much control over someone’s life with just a scalpel in her hand. Maybe I have no control over my own life and that’s why I am so addicted to the control of over someone else’s.

I open my eyes when I feel a tug on the hem of my surgical scrub. I look down to find a small girl with a bob haircut and uneven bangs, which look like she may have cut them herself. She’s carrying a leather bag pack that seems too heavy for her spine. There’s also a cotton tag on her public school uniform that says she is a seventh grader. However, her malnourished appearance and small stature make the girl looks like she’s no more than ten years old. “Doctor,” she tugs the hem of my surgical scrub again. The bruise on her round cheek and the cut mark across her forehead grab my attention.

“Hey kiddo.” I crouch to the girl’s level and say, “Let me take a look at your forehead.”

She flinches away at my touch. “Please help my mother first, Doctor.”

I cock my head curiously, “Where’s your mother?

The girl raises her tiny hand and points her finger at the Emergency Room’s sliding door as a patient trolley rushes through it. The paramedics shout, “Incoming!” I’m not sure how the girl managed to get into the hospital before her mother but she is the daughter of the patient I have been waiting for. I rush to the trolley and a group of surgical residents flock after me.

“Who’s the attending surgeon in charge?” the paramedic calls out and looks at the surgical residents, who happen to be all male. Even though medical schools are trying to recruit more women to create diversity, trauma surgery is still a heavily male dominated field.

“I am,” I announce.

The paramedic turns to me, surprised to hear a female voice. He regains his composure and speaks professionally, “This is Mrs. Sang Boonsawang. 37-year-old female. Victim of an acid attack.”

I look at the patient and realize that the damage may have been more extensive than the report. Her ear cartilage is partly destroyed and deafness may occur. Her eyelids are burned off, leaving the eyes extremely dry and prone to blindness. Her mouth becomes shrunken and her lips are partly damaged, exposing her teeth. She may lose her mouth’s full range of motion. Eating and speaking can also become difficult. In addition, she faces the possibility of septicemia, renal failure, skin depigmentation, and even death.

I look at one of the residents and say, “You.” The resident turns his attention to me. “Prep OR 7 and scrub in.”

I turn to another resident. “And you.” I look around the Emergency Room, trying to find the patient’s daughter but have no luck. I turn back to the resident, “Find a 13-year old girl who looks more like she’s 10. She has a laceration to her forehead. Make sure she’s all stitched up.”

The patient is wheeled into the pre operative area of the theatre suite. She is convulsing in pain and trying to cry out but no voice follows. It is possible that her vocal cord is damaged as well. Her arms and legs are secured to the operating table with bonds that are strong but padded so she won’t hurt herself as she struggles.

“Relax, I’m here to help you through this.” The anesthesiologist says. Because the patient’s nostrils have been damaged, giving her an anesthesia through a gas mask isn’t optimal. Instead, the anesthesiologist inserts a small plastic tube into one of the veins on the patient’s backhand. He then puts a blood pressure cuff around the patient’s arm and attaches ECG electrodes on her chest.

The patient is then wheeled into the operating theatre and slides onto the metallic table. She is still awake at this stage. “We’re putting you to sleep now so you won’t feel any pain,” says the anesthesiologist. It will take about two minutes to get the equipment plugged in and for the patient to fall asleep.

Her breathing finally slows down, indicating that the anesthesia worked. I turn to one of the scrub nurses and stretch out my gloved hand, “Scalpel, please.” The nurse hands the sharp object to me. I press the instrument to the patient’s body and open her up like a juicy peach. I am in control now.

The surgery is a success. The patient is transferred to the recovery area for a short while, and then returns to her room on the ward. However, she is still in critical condition and complications may arise during her recovery. Even if the patient recovers physically, acid assault survivors usually face social implications. Such attacks typically leave victims handicapped in some ways, rendering them dependent on either their spouse or family for everyday activities, such as eating and running errands. In some cases, acid victims are psychologically persecuted. Despite having operated on a few acid assault cases myself, I rarely see the issues covered in the news. The media overwhelmingly avoids reporting acid attack related violence. If covered, the description of the attack is minimized and sometimes the media blames the victims, omits women’s voices, and treats husbands who commit these crimes sympathetically.

I enter the waiting room, which is empty except for the victim’s daughter sitting on the hospital bench. She appears to be engrossed in a hardcover government issued biology textbook. I remember reading an earlier edition of the textbook when I was in middle school. When the girl hears me approaching, she asks without tearing her eyes away from the text, “Is my mother going to be alright?”

“The surgery was successful but we still have to watch out for any sign of complications,” I say. The girl nods but continues to read. Usually, I would leave the room at this point. I’ve done my job as a physician by telling a relative about the patient’s condition.

However, I find myself trying to strike up a conversation with this girl. I ask, “How did you manage to get to the hospital before the paramedics came in with your mother?”

Once again, the girl speaks without looking up from her textbook, “I was at school when it happened. I heard that it was severe so I rushed to the nearest city hospital because I knew the local clinics wouldn’t be able to handle it.”

Impressed, I can’t help but compliment her. “You’re one smart girl.”

The girl finally looks up to give me an appreciative smile. That’s when I notice the gash across her forehead. I thought I told the resident to stitch her up. The sight of the girl’s bleeding forehead sets off my rage. I’m going to make that resident’s life a living hell. I look down to the girl and say quietly, “Wait right here. I’ll go get a suture kit to patch you up real quick.”

I smile reassuringly and turn around. I look up to find a brawny man wearing a hospital gown. He resembles a bear more than a man. Despite the patchy, unkempt beard and thick glaze over his eyes, his eyes bear a striking similarity to mine. His hand traces the hospital wall slowly and he limps towards me. Suddenly, he trips and I immediately rush to his side. Just when my lips are forming his name, his fingers lock around my throat and he says in a deep voice, “It’s good to see you again, sister.” He spits out the last word like venom. His grip tightens. Oxygen is sucked out of my lungs and I am losing the battle to hold onto my consciousness.

“Sticks and stones will break my bones

But words will never hurt me”

I first heard of the Sticks and Stones children’s nursery rhyme when a group of English missionaries came to our village when I was in pre-school. We call these towering, pale foreigners ‘Farang,’ which is also a Thai word for the guava fruit. I was curious as to why we call them guava because the two bear no similarities at all. One is green and delicious. The other is white, at least the ones I have seen when I was younger. Most importantly, I doubt that a foreigner tastes as a good as a guava. After days of burying myself in the public library, I finally learn that foreigners are called Farang because the French were the first Europeans to establish ties with Thailand. I guess the words Francais and Farang sound close enough that they become interchangeable.

Even though it has been years since those Farang missionaries have taught me the meaning behind the Stick and Stones nursery rhyme, I disagree with the lesson behind it. The rhyme persuades the victim of verbal assaults to ignore the pain that comes from words, to refrain from retaliation, and to remain calm and good-natured because words can’t break your bones.

I have been broken physically countless times at the hands of my drunken father. But those broken bones never hurt me like words do.

There were two times words destroyed me.

The first time was when I learned about the devastating impact my mother’s illness had done to our family and what it could continue to do.

I was lying on the hospital with my back exposed. The nurses had just finished rinsing my burned skin with cool water and left to retrieve antibiotic ointments. I recalled crying in pain at each contact to the open blisters on my back.

I saw my brother, Awut, walked into the room. He approached me and I noticed the dirt stains on his round cheeks. He kept a straight face and said, “I just gave the police a statement about the fire accident.”

The memories of him holding an oil container and lighter crept back to me. I avoided his eye contacts. I said quietly, “An accident huh?” Maybe I was mistaken. Maybe I was imagining things when pain from the fire consumed me.

“That’s what I told the police,” Awut replied stoically. I sighed in relief. Of course, my sweet older brother who cried at the most mundane things wouldn’t do the unimaginable. “But just between you and me,” My train of thought suddenly stopped when Awut continued in a cold, distant voice, “Father shouldn’t have left his lighter within a child’s reach.”

My face, the once blank canvas, broke – first into confusion, then shock and finally realization. My mind witnessed wave after wave of emotion; as it crashed down, my lips trembled slightly. Before I could utter a word, I heard the door propped open. My brother’s back straightened and he asked, “Doctor, do you have news about our mother?”

The doctor led Awut to a seat and cleared his throat, “You might want to sit down for this.”

I blocked out all the noises in the room and just stared at the glass of water on the table stand nearby my hospital bed. Through the water in the glass, I saw a distorted image of myself. My eyes traveled up to where a wound licked across my forehead, singeing away my brows but missing my eyes. The scent of blood curled into my nose, down into my throat, squeezing it tight with despair. I was brought back to the memory when a shaman whipped my mother repeatedly with the dried stingray tail. I tried to stop him and I was hurt as a result. But it didn’t matter at that time because my mother was alive. All those years that I thought she ran off with another family was a lie. She was actually sick. My father had hidden her away from the world because he was ashamed of her mental illness. When her conditions worsened, he paid an undertaker to fake her death so he could hire a shaman to drive my mother’s illness away without suspicions.

But by the time the hospital ambulance arrived after the fire, my mother’s health had deteriorated due to constant beating and starvation. Not long after her hospitalization, she passed away. I also found out from the doctors what mental illness my mother was suffering from. I had to ask the doctor to repeat the name of the disease twice because it was in a foreign language. The disease was named after a Farang physician, George Huntington, who wrote about the illness in the late 1800s.

The doctor concluded that my mom had Huntington’s disease; a rare mental illness often described as a deadly combination of Alzheimer’s, schizophrenia, and Parkinson’s. The doctor explained that in Thailand, there has only been one reported case in the past twenty years. However, this low number may result from under reporting and the extrapolated statistics of Huntington’s disease prevalence in Thailand is approximately 2,000 people.

A few key words seared into my memory regarding this disease:

  1. 50 % chances of inheritance
  2. Symptoms begin at age 30 to 50
  3. Losing control of mind and body
  4. Incurable

Early signs of the disease vary greatly from person to person. Behavioral symptoms may include mood swing, anxiety, memory loss or hallucinations. Physical symptoms progress from clumsiness and loss of coordination to the point where speech is slurred and vital functions, such as swallowing, eating, speaking, and walking, are abysmal.

I took in the doctor’s description of the symptoms. My first response was denial. From what I remembered, my mom was an adventurous woman who loved to take Awut and me to swim in the lake. But then I recalled how her body twitched uncontrollably when I encountered her in father’s praying room. Coupled with Awut’s account of her incorrigible speech, the doctor’s description of the disease my mom was suffering from sounded accurate.

My second response was anger—anger of what my mom had to go through and anger towards my father for putting her through more suffering. But selfishly, I was most angry at the fact that my brother and I could inherit this devastating curse at just a coin flip away.

I recalled the doctor saying there’s a genetic test I could take to see if I carry the gene for the disease. Since there is no cure anyway, I didn’t want to know. But, my brother believed that knowledge is power.

The second time words destroyed me was two weeks after Awut’s eighteenth birthday when he told me his genetic test came back positive.

For more information on Huntington’s Disease and its symptoms, please refer to this our articles.

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